Social determinants of health amplify stroke risk in adults younger than 75 years

Good to know you are doing ABSOLUTELY FUCKING NOTHING ON STROKE EXCEPT TRYING TO BLAME THE PATIENT.  Come back when you do something useful.

Social determinants of health amplify stroke risk in adults younger than 75 years

By Scott Buzby

Among adults younger than 75 years, those with multiple social determinants of health were at more than a 2.5-fold greater risk for stroke than those without any, according to new data from the REGARDS study.

Determinants most strongly associated with stroke were race, education, income, ZIP code poverty, health insurance, social isolation and residence in one of the 10 lowest-ranked states for public health infrastructure. (The link doesn't name the states and is out-of-date besides on WHO reclassifying stroke in 2006 not being in CVD anymore.)

Source: Adobe Stock.

Even after adjustment for confounding physiological factors, individuals younger than 75 years with three or more social determinants of health were at approximately 50% greater risk for stroke compared with those without any.
“While prevention and better control of stroke risk factors cannot entirely overcome the influence of the cumulative burden of social determinants of health, considering these factors may substantially reduce overall risks,” Evgeniya Reshetnyak, PhD, senior research data analyst in the department of medicine at Weill Cornell Medical College in New York, and colleagues wrote. “While most physicians likely already recognize that certain demographic groups face poor health outcomes, our study elucidates the magnitude of this residual risk, which has not yet been reported.”
For this analysis published in Stroke, researchers assessed 27,813 participants in the REGARDS trial aged at least 45 years (mean age, 65 years; 55% women; 40% Black) to determine individual and cumulative impact of social determinants of health on stroke.
Among participants younger than 75 years, researchers observed an increasing trend in risk for stroke as the total number of social determinants of health increased compared with individuals without any (P for trend = .0002):

• one social determinant of health (HR = 1.26; 95% CI, 1.02-1.55);
• two social determinants of health (HR = 1.38; 95% CI, 1.12-1.71); and
• three or more social determinants of health (HR = 1.51; 95% CI, 1.21-1.89).

The relationship between social determinants of health and stroke did not reach statistical significance among participants aged at least 75 years (P for trend = .97).
“Individuals with multiple social determinants of health such as Black women living in impoverished neighborhoods in the Southeast may be excellent targets for focused interventions to reduce incidence of strokes,” the researchers wrote. “Health care professionals should consider heightening their vigilance to prevent the development of risk factors and achieve improved physiological risk factor control in persons with multiple social determinants of health. Elimination of disparities in the incidence of stroke may require societal interventions targeted at social determinants of health, especially in younger individuals.”